There is no doubt that feeding a fussy toddler can be one of the most frustrating aspects of being a parent.
Goodstart Early Learning senior occupational therapist Sally Fitzgerald and senior speech pathologist, Tiffany Noble say the journey of picky eating and problem feeding is one that many families face on a daily basis.
One day, a child might enjoy trying new foods and is curious about the taste and texture, the next day, he or she is battling over food at the dinner table.
There are reasons why this happens, and there are some simple steps you can work through to enhance the experience of mealtimes for children and parents alike.
Learning about the world
Ms Fitzgerald says that as we evolve from milk to solid food, we start to learn about the world.
“Babies begin to develop curiosity around food, what is safe, what is fun and what to trust. When solids are first introduced it is a messy endeavour. This is important. The messy play with food supports a child’s curiosity and trust in this foreign substance we are asking them to eat.”
Ms Noble agrees, saying “As a child experiences success in this learning, they can become more confident in exploring other new foods. Also, from a mechanical perspective, children are developing their oro-motor (mouth muscles) skills in terms of the strength of muscles and how co-ordinated their movements are. These skills are important for children to be able to hold foods in their mouth, chew and swallow them successfully.”
As time goes on, children start to take more risks with food flavours, textures, types and temperatures, as well as with the environments they eat in and with the different people offering food.
This, says Ms Fitzgerald, is when we need to talk about trust. Children rely on adults to test the world first – children need adults to notice and respond to their non-verbal cues, to support their emotional regulation and to explain what’s happening in the world.
“Children put a huge amount of unspoken trust in adults,” Ms Fitzgerald says. Therefore, when we talk about food, we need to acknowledge where children are at developmentally.
Ms Noble says we can reduce anxiety around food by simply talking about it, describing the process and labelling what is happening for children during a mealtime.
For example, Johnny used to love spaghetti bolognaise but one night he stopped and would no longer eat it. On this night, Grandma was looking after Johnny and served spaghetti which was too hot and burnt the roof of his mouth. Because Johnny was only two years old, he couldn’t easily communicate what had happened nor did he understand entirely, he just knew that the spaghetti ‘hurt’ him. His response to avoid this ‘hurt’ was to stop eating or become very selective. Grandma said he couldn’t have any ice cream because he didn’t eat his spaghetti.
In this example, Johnny lost his trust in the food. He didn’t understand that the food can be cooled down and Grandma didn’t know what was wrong. This was not anybody’s fault, but an example of how quickly trust and communication regarding eating can break down.
Children who don’t have the communication skills to easily say what is happening for them, need adults to interpret what might be happening for them and to support their reasoning.
Ms Fitzgerald says she has many examples of where she had seen children lose their trust in food – when they have almost choked on something, where food looked the same but tasted different, where food looked slimy or smelt strange. Children will then develop an opinion or story around the food, and without support, ‘picky eating’ can evolve.
Here are some common questions asked by parents and some strategies to help:
What is behind the fussy eating? What is causing it and how do I fix it?
It’s important to remember that eating is only instinctual in the first month of life, after that it becomes a learned behaviour. If you have a child that is a fussy eater then it’s important to explore their physical and sensory relationship with food as well as their ability to manage food when they do eat.
The overall goal of supporting children who experience difficulty eating is to create a situation which positively reinforces normal, healthy eating patterns. The following tips can help:
Repetition
The more you can make about the meal the same, the more predictable it becomes and the easier it is to learn. For example, are meals:
- Eaten in the same room?
- At the same table?
- Using the same utensils?
Role modelling
Adults are very important role models and can support children to understand what to do with food. For example:
- Over-emphasize chewing to show the way our mouths move to manage food.
- Exaggerate the swallowing process to make the ‘hidden parts’ of eating more visible.
- Describe the food moving down to the stomach to explain the whole process to develop understanding.
Positive reinforcement
We need to ensure ANY interaction with food is reinforced, as this interaction is the child learning about the food. New foods need to be presented repeatedly in small amounts that are not daunting with positive reinforcement for any interactions with the new food. The interaction might mean the child is:
- Looking at the food
- Smelling the food
- Touching the food
- Putting the food in their mouth etc.
Make the food less "new" by first introducing it to the child on the table only
I think my child is a fussy eater, how can I support them to try new foods?
Eating is the most complex sensory and motor task there is, in fact there are 32 steps to eating. So to begin with, just describing and talking about the food is a great way to build familiarity and confidence. Then, if your child feels okay, encourage them to touch new foods and continue to build up their experience with the food in small steps.
The goal is to develop a positive learning relationship with food. It might be worth considering exploring foods in terms of the 5 senses – what can you and your child can see, smell, hear, touch and eventually, taste. Some ideas to try:
- Make mealtimes fun
- Ensure there is predictability around the routine of mealtime so the new food is the only unfamiliar aspect
- Get messy with food
- Encourage your child to help with cooking and food preparation
- Get the whole family involved in ‘family meals’ – place the food in the middle and the children are able to serve themselves and choose what they would like to put on their plate
- Talk about the sensory properties of food (i.e. what it sounds, smells, looks, feels, tastes like) – be really descriptive and specific; for example “this cracker is really crunchy, listen to how it crunches between my big teeth at the back of my mouth, crunch, crunch, crunch”
- Offer a large variety of foods including foods you know your child likes. This will ensure the child has success with some food – even if it is familiar food. This can support the child to feel accomplished in their learning.
I have been told ‘if a child is hungry they will eat’ is this true? Should I take a ‘tough love’ approach?
No! Research has shown that this concept is not true, particularly for those already experiencing eating difficulties and that ‘tough love’ can result in further challenges. Children are hospitalised every day with food related issues, and it’s important that we address them properly.
If learning about food is unpleasant and children have experienced this repeatedly, their bodies can turn off their appetites (Booth, 1990 as cited in Toomey, 2010).
While you are working through ‘fussy eating’ challenges it’s important that children still receive daily nutrition. Ensuring children are given foods they enjoy and are comfortable eating whilst exploring new foods is critical.
So as a parent what should I ‘live with’ versus what should I push my child to do when it comes to eating?
It’s not necessarily about pushing them to do something, but starting the journey of supporting a positive and fun relationship with food. Playing with and talking about food is so important as is making sure you try and implement a regular mealtime routine including enough time and space for your child to eat.
We also need to make sure we are listening to what they are communicating and respecting their needs at the time. This will ensure we don’t ‘force’ children to eat something they’re not yet comfortable or confident with.
Quick tip: Offer choices and celebrate any interaction with new foods, even just talking about the food itself.
Who can I go to for more help?
If your child is experiencing symptoms of fussy eating or problem feeding we encourage you to seek professional support. We recommend accessing Occupational Therapy, Speech Pathology, Psychology or Dietetics advice from those trained in the Sequential Oral Sensory (S.O.S) approach to feeding development. Your GP may be able to support a referral or provide recommendations of the different services available in your local area.
About the author
Sally Fitzgerald is a trained Paediatric Occupational Therapist and Tiffany Noble is a trained speech pathologist. Both practitioners hold senior positions and are responsible for leading Goodstart’s national team of Occupational Therapists and Speech Pathologists respectively within Goodstart’s Enhancing Children’s Outcomes (EChO) centres. Sally and Tiffany further support educators across our network with professional development opportunities aimed at enhancing children’s sensory, play, motor, communication and emergent literacy development in early learning environments.
References:
Toomey, K.A. (2010). Common reasons children won’t eat.
Toomey, K.A (2010). Introduction to the SOS (Sequential-Oral-Sensory) Approach to Feeding Program.
Toomey, K.A. (2010). When children won’t eat: Understanding the “whys” and how to help.